[Instrumental diagnosis of peripheral arterial occlusive disease]

The increasing frequency of peripheral occlusive arterial disease in the general population emphasizes the need of suitable methods for early detection of this disease. This overview summarizes the methods of current use of angiologic investigation. Their sensitivity and practicability are critically discussed. Mechanical and electronic oscillography are simple screening methods and allow a slight localization of arterial occlusive disease. Exercise tests increase the sensitivity of oscillographic methods. Continuous wave Doppler-ultrasound can be used for measuring peripheral arterial pressure, directional or pulsed Doppler-ultrasound are needed for the determination of flow direction and for registration of flow-pressure curves. Multichannel pulsed Doppler-ultrasound is needed for quantitative flow registration in determined arteries. Detailed high quality pictures of the arterial structures can be obtained by high resolution B-mode scanners-while information on flow properties is given by frequency-analysis of Doppler signals achieved in duplex scans or color-coded scans. Plethysmography is still the standard method for quantitative flow determination in upper and lower extremities, suitable for the evaluation of the vascular capacity of the examined member. Capillaroscopy gives a direct view in the situation of microcirculation, which is very valuable for the management of diabetic microangiopathy and collagen diseases. Thermography offers the opportunity of registration of impressive imaging of functional vascular reactions.